Clinical insights...with Steven Judge
16th Sep, 2021


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Jacqui Fahey (00:03): Welcome to Common Ground, a podcast series discussing new research and interesting projects in the field of complementary medicine. Hello, my name is Jacqui Fahey, Head of Education at is a digital platform, a professional health resource, and a distribution service all in one. 

Firstly, I would like to begin by acknowledging the Gadigal people of the Eora nation as the traditional custodians on the land on which we gather here. 

Mental health is a key component of overall health and wellbeing. Mental illness is very common. 

One in five Australians, aged 16 to 85 experience a mental illness in any year. The most common mental illnesses are depressive/anxiety and substance use disorder. These three types of mental illnesses often occur in combination.

Within the complementary medicine profession, Australian naturopaths report frequently treating patients with diagnosed illness of national importance, such as insomnia, depression/anxiety, menstrual disorders, and arthritis.

Total rate of Naturopathic consultations in the general population is comparable to other registered health professions, such as acupuncturists and osteopaths. 

Naturopathy is a holistic system that incorporates a range of treatments and natural therapies with some underlying core philosophies that include an expanded individual centred and holistic approach to healthcare, addressing the underlying cause or causes of ill health, treating the whole person not just the disease or the symptoms, and utilising non-invasive approaches such as herbal medicines and nutrients.

Jacqui Fahey (1:56): Today on Common Ground, I'll be speaking with Steven Judge. Steven is a clinical naturopath and nutritionist practicing in Surry Hills at the holistic medical centre where he is also a Director. He has a special interest in chronic digestive disorders and mental health and a particular affinity for treating histamine intolerance. 

Steven has a practical and down to earth approach in clinic and despite the complexity of some cases, he enjoys breaking things down for his clients in an easy to understand way that is focused on empowering his clients to take control of their health by shifting their perspective. 

Welcome to Common Ground, Steven.

Steven Judge (2:39): Thanks Jacqui, pleasure to be here.

Jacqui Fahey (2:41): So Steven, we would love to hear a little bit about yourself. What led you to practicing in naturopathic medicine?

Steven Judge (2:44): Yeah, well like many of my colleagues, I assume I pretty much went on my mission to find out the deeper underlying reasons for my own health issues at the time, which were pretty much centred around pretty chronic gut issues and kind of intense anxiety. You know, I was young, I partied pretty hard at the time. I was a young music student straight out of high school, so very much the rock and roll lifestyle. I was working six days a week, 10 hours a day in hospitality. You know, I had absolutely no concept of health let alone what a naturopath was. But luckily what I eventually did go and try to seek, you know, general conventional medical help that's out there, visiting doctors getting a basic bloods done and being told everything was fine on paper. I was probably distressed. I had a genetic issue and I needed antidepressants, you know, despite being so disconnected from myself and my body at that time at that age, some little thing inside of me was like, no, there has to be more to it than that.

Steven Judge (3:53): Like this doesn't feel right today. So then I really just started, I got, you know, an intense desire to get into fitness at the time and got a PT and who also introduced me to yoga at the time, which I'm forever grateful. It's a big part of my life now. And in my pursuit of developing fitness, there was, there was something about nutritional science and biochem, it just really fascinated me at the time. And I dunno where it came from but I honestly remember just going home and googling nutrition course study in Sydney, clicked on the first page that popped up, which happened to be ACNT, checked out their curriculum and thought, that is exactly what I want to learn about. And then I just started studying, you know, part-time three nights a week and eventually went on to completing the naturopathic advanced diploma, and then a bachelor of health science in naturopathy once I caught the bug, so to speak and was so inspired by the lecturers I met during my studies.

So it's all quite organic, how I got into it. You know, I just kind of followed my intellectual instinct at the time. There was never anything at the forefront of my mind in regards to wanting a one-on-one private practice career in this field. So it's always great for me to reflect on that and how I got here and you remember why I'm doing it, which is very much related to how inspired and life-changing it was to me to learn about and just put into practice everything for myself, which is why I did it in the first place, you know, and yeah, that's kind of how I got into it.

Jacqui Fahey (5:33): Beautiful. Thank you for sharing. With one of your specialties being in mental health, how can naturopathy in your experience support mental health?

Steven Judge (5:40): Yeah, I guess in so many ways, that I guess how I frame it too many clients that I meet, when I'm with them, one-on-one, is essentially that, you know, by fortifying the physical body, you know, and really addressing everything physiologically speaking that could be out of balance, which is a huge variety of things, you know, it could, people could be hugely B12 and iron deficient or, you know, any kind of nutrients deficient. They could have a chronic gut issue, which is driving inflammation, affecting the gut-brain axis. They could just, you know, back to basics could have a very inflammatory diet and aren't moving their body. But, you know, in terms of, a lot of people come to us and they perhaps, you know, seeing a psychologist or seeing a therapist and trying medication and they are still stuck. So how I frame it with clients particularly is that, look, if we can really properly fortify your physical body through dietary and nutritional medicine and or herbal medicine and all of the lifestyle medicine support, not only to people start feeling better physically and mentally, but then they can go into the deeper stuff and address the emotional, mental, psychological, and, or spiritual stuff at the root of everything.

But if we can really support them physically and fortify that physical body and people, clients really, when I explained it to them in that way, they really resonate with that because that has been their experience. They’re trying to do all these things, psychologically speaking as if it's just a mind issue, but physiologically it's usually so much out of balance. So naturopathy I think has massive, massive potential, which is already evident in my experience. 

Jacqui Fahey (7:33): Yes, it's a holistic approach, isn't it?

Steven Judge (7:35): Yeah. Totally

Jacqui Fahey (7:36): Are there any particular key herbs or nutrients that you find work well for anxiety and stress?

Steven Judge (07:42): Yes. Gosh, there’s so many. But you know, without any testing, let's say, I do use a lot of testing, but let's say I do set that up, but I want to get people started, you know without any testing, you know, again, back to basics, rarely does anyone leave without some sort of magnesium, zinc and B complex situation just to get them started. For the clients who are really sensitive, you know, potentially genomically speaking, with methylation issues and stuff, you know, I'll usually make sure it's in a B complex that they're taking, folinic and hydroxy forms of active folate and B12 rather than the methyl. You know, there's kind of a subset of people, whether it's methyls can just push a cycle too hard, get a lot of side effects. You know, I am using a lot more amino acids these days, they're quite cheap cost effective, but also kind of very effective at least symptomatically while with wanting to work on deeper underlying issues.

So I'm a big fan of l-theanine for its GABA, serotonin and dopamine modulating activity ,that you know, is famous for simultaneously reducing anxiety while improving focus and cognition. It's like relaxing without being sedating. Glycine, I love, another cheap, easy intervention. I give it to people quite frequently, just a very small metric teaspoon before bed. Helps quite a lot with sleep onset and maintenance. Any of that, it's got a whole other range of benefits kind of helps make glutathione and stuff like that, but for the sleep factor, it's very cool. And N-Acetyl-Cysteine (NAC), I’m a huge fan now, cheap and very effective intervention. You know, again a wide range of benefits, liver antioxidant, antiviral, but for the very anxiety prone folk, anyone dealing with anything in the addiction realm, you know, clients trying to reduce and or quit alcohol and cigarettes and you know, there studies and I say, reducing withdrawal symptoms and preventing relapse in patients trying to stop doing cocaine.

You know, so NAC is an absolute winner because a lot of patients in the mental health space are really anxious and kind of self-medicating with something. So the NAC is really nice there. And again, when you show them the information on it, they get really inspired to kind of want to take it. And I say, it's a winner. 

Steven Judge (10:46): Yeah, herbs, there's so many, I guess my top four, saffron would hands down, have to be a winner. Again, clinical trials on garden variety anxiety through to OCD, more complex presentations, but especially cause a lot of people are on medications. And I do love St John's wort, but a lot of people can’t take St. John's wort. You know, a lot of women are on the pill too, and are having a lot of issues with anxiety I find due to the copper issue with the pill.

So a lot of saffron, I get really amazing results. Getting people started while we're waiting, mixing saffron and tonics. And yeah, Withania, Rhodiola, they would have to be in my top four. For people who just can't do liquids, am I allowed to talk about product names? Okay. So, you know what's the protocols Neuroenhance, I think it's an Orthoplex product. 

So they've got all four of those herbs in there, you know, St John’s wort, Saffron, Withania, Rhodiola. I've yet to give that to someone and they haven't reported back saying they feel much better and are energised, less anxious. So the products, you know, it’s all in there, but again, there is St. John's wort, so some people might not be able to have that. So much potential with herbs, so those four would have to be my big ones. 

Jacqui Fahey (12:14): Yes, Steven what helps with compliance? such as clinical tips, a program that you might put together or education you just mentioned earlier, information that you share around, say a herb or a nutrient, what helps clients with that?

Steven Judge (12:27): Yeah, I guess I think in my own practice, what I find is quite useful is, on their treatment plan document, you know, I've kind of got their goals listed, whatever we're doing, we want to support their gut or reduce their anxiety, whatever their things are but directly under their goals is a section called potential underlying factors. And I've got ready to go, like a template of my own, where I will paste onto people's treatment plans, kind of the key underlying issues we need to focus on and what those issues mean and why they're related to what they're currently experiencing. So, you know, I've got a bit of a spiel there on gut dysbiosis and leaky gut and how that directly affects mental health. And I will, under some of these, I will list other particular nutrients or interventions that are helpful with a little hyperlink, that'll take them to my own website or even someone else's that site, you know, someone, a functional medicine or naturopathic practitioner out there has written some amazing piece and I'll just divert them out there or to a book or something, but that, you know, practically speaking, that's been really helpful. And, you know, in terms of mental health in particular, I'm talking about the concept, not a concept is kind of a known phenomenon, but of HPA axis dysfunction to a lot of clients, mostly all of them, I would say actually, thinking about it, because to some degree with most conditions, but even in mental health, it's clinically documented. This, what I explained to clients in this section under HPA axis dysfunction is that a dysfunctional stress response is like key, key, kind of perpetuating factor in why they're not getting well.

Steven Judge (14:37): And clients love that being explained to them because, you know, they might've been told very briefly and, you know, kind of matter of factly that, ah, look, I think it's just stress related. You know, someone would have said that to them, doctor any kind of practitioner, but not really explained to them the connection between this symptoms and that it is like a medical diagnostic kind of term out there to explain physiologically how it's part related to depression. You know? And so in this section I will list some hyperlinks. So, you know, HPA axis dysfunction. This is why zinc is very important for this and how B vitamins, this is why it's important for this and how, just little things like that. And they're just templates I've made in a ready to go, but it's very practical and it really helps. I find clients understand why they're taking what they're taking and doing what they're doing and why are we going to test for what I think we should test for because I also find that testing, when you explain the deep potential underlying issues and then what tests can help gain some more insight into that issue and they're really on board.

Jacqui Fahey (15:50): For our listeners today, could you just briefly explain, even if it's brief, HPA axis dysfunction? What is that for some of our listeners out there that might be not being familiar with this term?

Steven Judge (16:00): Yeah, so like I just say it to client’s, HPA axis dysfunction is essentially like a very dysfunctional stress response. So what I say to clients is that look, the stress response is very useful in the face of immediate threat. You know, we had to run from a lion. Cool, very useful we've ideally  needed occasionally. The issue is with that stress response is that in the west and in the modern world, we trigger it a thousand times a day, potentially. So the downstream effect of that is, you know, there should be, so the hypothalamic pituitary adrenal axis, you know, this signalling pathway should work like a negative feedback system. So we identify a stressor, HPA axis is triggered to send a message to the adrenal glands to pump out cortisol and adrenaline, but that can be triggered so constantly that we almost become desensitised to our own stress hormones, and it doesn't switch off as it should. And it becomes very dysfunctional and fluctuates up and down and you know, and when this starts happening, that's when I can go back to clients and say, this can be why your libido is all over the place, or you were kind of randomly anxious at certain parts of the day or your gut is shutting down and not functioning properly. It's a very cool concept to explain to clients and once they understand it, I do find they're kind of much more on board with trying to heal themselves.

Jacqui Fahey (17:38): That makes sense. Absolutely. And any practical tips you offer patients in clinic with their day to day, such as some apps that they might work with or meditation, do you sort of integrate any of those into your naturopathic practice?

Steven Judge (17:57): Look, I do upon first meeting people, you know, funnily enough, it's rare in the first appointment, especially that I'm saying you have to go do this, in regards to meditation, kind of interventions, because again, I frame it and I frame that from the perspective that look, if we can fortify, you know, I've said to people we all know that we need to, we all will benefit a lot from these activities, right? We know that you don't need me to sit there and tell you, I think you should meditate. But so, I frame it from the perspective that, you know, if we can fortify our physical body first and get you feeling better, physically, and therefore mentally you will be more inspired to go there with those practices. Cause you're not, you know, if you're telling a really anxious person sit down and meditate silently, you’re never going to see them again.

It's, you know, it doesn't, it could make people feel very lower, so you know, so yeah, exactly. But I do plant a seed, you know, I say, look, we're going to go there, but you know, let's focus on getting you feeling better first. And when we do go there, look, I have to find it, people who are really anxious and or depressed, are likely very dissociated from their body, you know, telling them to do breath work and silently meditate isn't always the best idea. So I courage many clients to consider getting into practices which really involves getting back into their body. So like gentle Hatha, yoga, yin yoga, or body scans style of mindfulness meditations. This can kind of help to start really ground people and connect to their mind body, so to speak and, you know, start gently getting into the process of being able to practice mindfulness and learn to sit with the uncomfortable.

I think many people can't deal with that more traditional meditation and breath work. They’re not even in their body yet, let alone be able to sit with their mind. So the body-based mindfulness work is a big winner for me in the hatha, yin style of yoga. But on top of that, look, I'll say I'm also a huge fan of trying to plant the seed. And if people aren't already getting them into regularly, some sort of vigorous, aerobic and resistance training. I encourage clients to really consider, you know, at some point making this a self-care priority. You know, we may not think of it at first as a tip for anxiety and stress. The resistance and aerobic training is really powerful antidepressant and gets, it gets people back in their body, you know? 

Jacqui Fahey (20:47): Yeh Beautiful. Very grounding isn't it? connecting back in the body.

Burnout is certainly increasing for some practitioners since COVID-19, no kidding. It’s really challenging times. What do you find supports you for conducting your clinical practice?

Steven Judge (21:13): Yeah. Look, variety of things. I guess look, I won’t, you know, tell people, again, it's one of those things that, so many things we know we should and could be doing, but don't. Maybe we won't be doing it for whatever reason, I guess, rather than telling people certain activities and stuff, look, there's a certain mindset that's really helped me with this, to figure out what I personally need to prevent burnout. Cause I was pretty burnt out. I don't know, 8 to 10 months ago, pretty consumed with, you know, COVID situation and my business. And you know, we're already dealing with burnout in general, working one-on-one and working with people. And you know, this thing that really hit home for me at the time to get me out of that and I've used this kind of mindset to this day, it's kind of a practice really, but I was actually listening to an interview between two functional medicine practitioners online.

And the same question was posed, this functional medicine practitioner, his name is Sachin Patel and he was interviewing Kelly Brogan, who is a holistic psychiatrist, slightly controversial, but you know, I kind of admirer like in psychiatry. But he asked her that question. He said, you know, functional medicine, medicine practitioners, you know, we're trying, we have so many causes. We feel we need to be there for, and we're working one on one and we're very prone to burnout. Like what would you say to these people? And her response was essentially, you know, it really comes back to like the Zen saying it's chop wood carry water. You know, it's like back to basics. Like once you hit that stage, it's like, okay, at the forefront of your mind really should be, you know, the commitment to exercising your choice to prioritise yourself. And that all you're really here to do is your self-care and that's it.

And there's this practice of discipline, but without self judgment, you know, cause I guess as healer, people in the healing profession there are so many courses we feel we need to be there for and things we need to understand and keep up, you know, up-to-date with every little micro detail of everything going on with the pandemic and we need to be on top of learning so many things in our profession. But if we kind of get into all this without first having shown up for ourselves and prioritising our own self-care rituals and that all becomes a big distraction and eventually will burn you out so that, so that may or may not resonate with other people. But at the time when I did get massive burn out, that really did help get me out of it and it was just back to basics for me and I was, you know, so I touch, reflect on, okay, well what are my self-care rituals?

Steven Judge (24:11): And am I prioritising them? And when am I going to schedule them in? And that's the non-negotiable. Yeah, that really helped me, you know, that whole interview is pretty inspiring for me as a practitioner. And really, again, it's a practice, you know? And so my, I guess my advice would be look maybe that mindset is very helpful that ‘chop wood carry water’ and just committing to exercising your choice, prioritising your self-care to the point of scheduling it in. And also, you know, but without the self judgment, if you fall out, which I have multiple times, you just fall out for a sec and acknowledge it and jump back in when you feel like it.

Jacqui Fahey (24:57): I hear you with that one. It's one of my favourite sayings is ‘ Be gentle with yourself’, you know, we can be quite hard on ourselves and expectational and it's just so important to  prioritise yourself, to keep the balance, to keep the joy. 

Steven Judge (25:21): Yeah, so for me that looks like, you know, hatha yoga every morning and personal training twice a week and they’re my non-negotiables at a minimum and there might be other things, but you know, that will fluctuate, but you know, just having some mindfulness around all that. But yeah I would recommend people hit up that interview. Very inspiring.

Jacqui Fahey (25:40): Nice. Thank you. Thanks for mentioning that. And I like it, your non-negotiables. Thank you. That's a new one for me. Well, thank you Steven for sharing your wisdom and experience today, you've shared some really valuable insights, so thank you for coming on Common Ground today. 

Steven Judge (25:51): Absolute pleasure. Thanks Jacqui. 

Jacqui Fahey (25:59): To our listeners, please subscribe to Common Ground, we appreciate your support and feel free to leave us a review. We'd love to hear from you. Thank you.

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